Practice Management Blog

Let’s face it. Patient focused customer service is critical to building and maintaining a practice.

There is a clear expectation that the business executive of a practice fills an important role in creating and maintaining superior customer service besides taking care of all of the other business related aspects of running the business side of the practice. So what happens when that key person leaves? Staff retires, moves away, get sick, or are asked to leave the practice. Executives experienced in the field of reproductive endocrinology and infertility are not found that easily. Taking the time necessary to get a qualified replacement can take months. In the meantime what do you do? By hiring an well-seasoned medical practice executive familiar with the Reproductive Endocrinology and Infertility (REI) field can fill an important void. First - their experience, imagination, and overall business acumen can not only hold the fort but may actually identify opportunities simply by bringing a fresh look to the practice.

Building a top tier infertility and in vitro fertilization practice takes more than having doctors and staff with the proper education and skills. The patients who come to you do so with high anxiety and fear that they cannot conceive a baby. In many instances these patients are extremely well informed and, due to the cost of infertility treatment, frequently are upper middle income patients. They have high expectations in service, communication, and physical ambience. In short, they are high maintenance patients.

Having established a proven track record of pregnancy results, especially if those results are with older women or couples where the problem resides with the male, the necessity to create a team environment is critical. Everyone from receptionist to the nurses to the lab techs and the doctors need to make the patient feel that the entire team is working together for the patient and will share in the emotional highs and lows that inevitably occur during treatment. The physical appearance of the facility must be more comforting than the typical clinical setting. Pictures, flowers, a comfortable waiting room, and current magazines and reading materials without dog eared corners all help to set a practice apart. One cardinal rule is to never mix an infertility practice with any other OBGYN specialty.

Second - having sensitivity to the above is a value added dimension necessary for ongoing success. An interim arrangement makes sense so the group can focus on what its mission is designed – helping couples achieve the dream of parenthood.

Third - Utilizing seasoned experts will help your practice bridge the "gap" phycially, and financially. Make sure you can continue doing what you do best - be a doctor!

Consider one of interim experts on Our Team like Jerry Otten to find out how we can help you!

Using the experience and expertise that I have gained as a health care consultant throughout the United State I my lecture is entitled " Ethical Duty and Obligation to Care ". I will also be drawing on my experiences internationally - I have had the priviledge of working in Albania, Honduras, India, The Dominican Republic.

Physicians are often concerned with their practice volume. There is the worry that when visit volume is down that they’ve got to fire up their marketing; create billboards, support more local initiatives and get their name out more. Some suggest the economy is poor, therefore their referrals are down. Others look at the amount of deductible and co-pay portion patients are now required to pay – and yes those factors all have the potential to impact volume. However, I have found it is often lack of identifying how to grow strategically, and identifying the gaps that are resulting in growth, yet still providing high quality service that provide the greatest return on investment (ROI) for practices. Growing a practice take a lot of work, it’s not just about the physician, the physicians’ quality or the facility. It is critical that each department in the organization needs to understand the importance of high quality customer service. As a consulting firm we are often engaged to help identify growth opportunities, develop strategies and to ensure sustainability. However, if services are not provided in a manner that embraces your patients with high quality customer service it might be time to rethink your processes.

How does your practice measure up when it comes to customer service? Are you willing to think beyond patient satisfaction scores? Is it okay to have 95% of your patients satisfied – what if 5% are dissatisfied, and that 5% tell their friends about how they don’t like your practice? It’s critical today to inspect all aspects of the practice to identify what makes the practice successful, but to think beyond and identify what barriers we have created for our patients.

Here are 3 things that we have found work to improve customer service in your medical practice:

1) DO IT RIGHT THE FIRST TIME Consider evaluating the work flow by department. As medical practices grow over time, they have added procedures and policies to ensure that their department is compliant with the “issue of the day / month /quarter.” Think about it, if we ask patients on the phone for their insurance information before their visit, verify their eligibility electronically before their visit and ask them for a copy of their insurance card at each visit ….. you start to see the redundancy. With the complexity of medical practices today, it is likely that there are other redundancies between departments in your practice as well. Consider flow charting the procedures, ensure that you are capturing the information you need to do your job, but not duplicative. Not only does duplication reduce patient satisfaction, but it costs the practice money.

2) FOCUS GROUPS Identify patients that would be willing to provide you feedback. Through a random selection process identify 6 to 8 patients that would be willing to participate in a focus group. Have the meeting facilitated by an objective person such as the office manager or the administrator. If you provide lunch and a gift certificate to Macy’s for $25.00, you might be surprised what kind of feedback they can provide to you. Make sure that you share the results of your focus group with your physicians. The results of the focus group might be surprising - comments may be very negative about the physicians, the front desk, or management. It is important that you report the results honestly, celebrate the positives and embrace the challenge of the negative. Often there are simple changes you can make to remedy the problem areas.

3) OUTSIDE EXPERTS Consider engaging an outside expert to help you understand the dynamics of the practice. Physicians often believe that consultants are helpful in a crisis, but having an outside facilitator help you review your workflow can be highly valuable. At Systems Consulting our team can accurately assess what is working well in your practice and what needs to be improved. We are also skilled in facilitating physician retreats to help educate the practice on what needs to be changed to provide high quality services. Typically we provide a one to two day on site visit with a ½ day retreat to help you get the organization in the growth mode. To learn more, visit our page -Medical Practice ConsultingOur team works nationally, to get you started, we offer a free 30 minute telephone conversation – call us today at 1-866-222-4488 to learn how our team can help you.

Okay, yes, I know, health care reform was passed. Way back in March 2010 the law (Patient Protection and Affordable Care Act) also now known as Obama care was passed. At that time many were worried, not unlike the early 90’s when health care was in a frenzy with “Hillary Care”. Of course the law was a mere 1900+ pages long, and it took months for even the experts to begin to grasp how this new legislation would be dramatically re-shaping our health economy. At that time, we can all admit that we really had no idea what was in store with health reform, but we were learning about some “new terms” such as ACO, Meaningful use and other words and phrases that seemed to provide more and more fear with physicians. At the same time, many hospitals started planting ideas about how prospective payments or bundling would be impacting physicians. Many feared that the day of the independent physician groups would soon be over, after all, the hospitals would need to “own all of the physicians” to make health reform really work.

Leaders of the health reform movement told us that the ACO model was coming. We also feared the change in regulation for decreasing the number of uninsured by way of increasing Medicaid patients. Many believed the only way to escape the fear would be to become employed by hospitals. Fast forward a few short months to the fall of 2010 when trade groups such as HFMA (Healthcare Financial Management Association) started to really provide us with some of the details about what health reform might mean. We learned that many of the key aspects of reform might actually help the physicians – for example, making the switch to electronic health records EHR or Electronic medical records would actually be subsidized by the government. We learned that soon physicians would be paid to provide some of the preventative health that we already provide. We also learned that there were suddenly varying opinions on what an a ACO would look like, particularly when it was clear that the regulations for ACO’s would be as complex as health reform and was the size of a medium large city yellow pages book. Back in the fall many were afraid, but groups that I’ve been working with in the last six months or so are seeing a changing tide.

Some of the really fundamentally components of health reform have been showing weakness. In fact, I believe that the direction of health reform continues to accelerate at an increasing pace in a negative direction. For example, it was one of the basic tenants of the reform was that it would provide coverage for all members of society – if you were an employer you would have to provide the coverage or face severe penalties. Interestingly enough, the Obama administration has been willing to sacrifice and has provided waivers (which by the way are not part of the statute) to employers. In fact, a recent article in the Wall Street Journal states that over 1,300 employers such as McDonalds have been granted such waivers. The article stated that we were “Waiving Obama Care Goodbye”. I frankly think it’s the tip of the iceberg.

If you read papers such as the Wall Street Journal you will notice more discussions about the very thing physicians were afraid of ACO’s. On June 13 one of the organizations that much of this alleged health reform was supposed to be patterned after, the famed Mayo Clinic, stated in the Star Tribune that they opposed key health reform provisions including the ACO’s. The article continued to not that the proposed regulations conflict with the way Mayo runs its Medicare operations. A recent opinion published, again in the wall street journal was entitled “The Accountable Care Fiasco”. In that article it states that “Even the models for health reform hate the HHS rules.

As we continue to ford through these changing tides of healthcare, we acknowledge that health care is broken, the complexities of health care are not improving, in fact they are becoming more complex.

If you would like to learn more about our opinions on health care, and how we can help you navigate give us a call 1-866-222-4488, we will be happy to work with you to educate you and your team.

Physicians today are struggling.They are concerned about “Obama Care”, declining reimbursement, and poor payer mix among other things.Actually, I would contend that they are concerned about what they don’t know.Much of the “reform” that has been touted has not really been articulated; in fact the ACO regulations were just recently published.It is human nature to be afraid of the unknown and today, from my perspective that is what physicians really fear the most.Physicians are contemplating selling their practices as never before with the fear of an ACO taking over all that they do.Before you sell consider the following options

1)Do you really “need” to sell your practice?Practices that have contemplated the sale question may not understand what their current compensation is compared to peers.That’s where a benchmark survey comes in.Do you know if your current practice is compensating you above your peers or lower.What does compensation if you are employed by a hospital look like?Did you know that there are benchmark compensation reports that show the variance between physicians employed by a hospital or those employed in private practice?

2) If you sell your practice what will change?Often physicians will be offered a lucrative contract to join the hospital’s medical group, but what happens in two years after being employed.As a consultant I have helped physicians negotiate the sale of their practice to a hospital, but I have also helped them transition back into a independent practice.Physicians are often surprised by the number of staff that they have loyally cared for over the years being adsorbed by the hospital, relocated to a central billing office or even dismissed from employment.Does the hospital have an “outreach program”, it’s likely they do, and it’s likely that they’ll want you to travel for them to help them “grow their market”.Be ready to put some miles on.This does not have to be a bad thing, finding complex, interesting cases can be very rewarding, but the time commitment can be significant, depending upon the market you’re working in and the market the hospital wants to grow.

3) How happy are other physicians that have sold their practices to the same hospital?Make sure that you do your own surveillance to identify what has been positive for other physicians who have made the transition to be employed by the hospital.Make sure that you talk with your colleagues in the same specialty, and get a good sample of physicians who have been employed for a year, two years or three years to get a good idea of the culture of being employed.

At Systems Consulting, we work with physicians to be objective, to evaluate their practice and help them to make decisions with objective data and benchmarks.Our team can help you to unravel to complexity of your practice and provide expert guidance.Call us today to learn more, we offer a free 30 minute telephone call to get you started.